Use of end-cutting needles in ultrasound-guided biopsy of neck lesions

Abstract

The management of a neck mass is dictated by its nature, location and extent. Pathological diagnosis by fine needle aspiration cytology (FNAC) or core biopsy is often required before proceeding to definitive treatment. It is not uncommon for the cytology result to come back as inadequate for various reasons. The unique design of the end-cutting biopsy needle in our experience makes it a good choice for use in obtaining both transcutaneous and intraoral biopsy under ultrasound guidance of neck lesions and serves as a useful alternative or adjunct to FNAC. Although there is, as yet, only a limited evidence base about end-cutting in comparison to side-cutting needles, they carry several potential advantages. Key Points • End-cutting needles are safe to use for lesions close to vital structures.• End-cutting needles yield sufficient tissue samples in a single pass.• End-cutting biopsy needles are a useful adjunct to FNAC.

Evaluation of vascular puncture needles with specific modifications for enhanced ultrasound visibility:In vitrostudy

“…In deep vein thrombus, poor visualization of the puncture needle during needle puncture of the popliteal vein is caused by the elevated echogenicity of the thrombus in the vessels and thick limb edema, with subcutaneous fat pushing the popliteal vein deep [13] . Therefore, modifications to improve visualization of the vascular puncture needle would improve safety during these procedures [17,[20][21][22][23][24][25][26] . Of the four modified needles assessed in the present study, the re-cut modification showed no significant increase in needle visibility compared with the control.…”

“…Previous studies have described devices for gauging the puncture angle and needle depth, and the use of fourdimensional US for improving needle visualization [17,18] . Biopsy needles and nerve-block needles with a specific coating or type of cut at the needle tip are commercially available for improving US needle visualization [19][20][21][22][23][24][25][26] . Nevertheless, no vascular needle has been devised specifically for this purpose.…”

Surgical anatomy of the nasopharynx

“…In general 18G or 20G Franseen needles are adequate for biopsy of lymph nodes. End-cutting biopsy needles guarantee adequate tissue for cytological examination, leading to less failure of FNAC (Yuen, Lee, Bhatia, Wong, & Ahuja, 2012).…”

A short review of basic head and neck interventional procedures in a general radiology department

“…However, our own experience [ 20 ] in using the Franseen trephine type needle with the serrated stylet tip showed it to be safe and of high yield in terms of adequacy and accuracy. The risk of injury to normal structures occult on ultrasound, such as the facial nerve within the parotid gland during needle advancement with the trocar in situ, is minimal and no greater than that of FNAC.…”